Guidelines for Dax Cowart Case Analysis Introduction In the following assignment

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Guidelines for Dax Cowart Case Analysis Introduction In the following assignment we will use a specific case to examine in more detail the intricacies of an ethical dilemma. I would like to introduce you to the story of Dax Cowart. Attached is an excerpt from a speech that Dax Cowart made several years ago, a speech that remains poignant for contemporary reflection. The story is heart breaking and challenges all the bounds of ethics and health care. As you listen to Dax, or read the transcript of his talk, think about the issues Dax discusses, especially in connection with capacity and the right to decline medical treatment. These are the stories and circumstances where ethics and health care collide and individuals are forced to make tough decisions. In thinking over your responses to the discussion questions, consider the concepts we have talked about in the modules to this point, such as personal moral values; bioethical principles; the need to weigh and prioritize competing moral interests; a healthcare professionals charge to provide ethical care and a patient’s right to self-determination. Instructions You will analyze Dax Cowart’s case by considering the following questions: You are Dax’s physician. How would you respond to Dax’s requests that you “let him die”? Would you continue to treat him against his wishes? Why or Why Not? After reviewing the case study (see Learning and Assessment Activities for this module), respond to the following questions in a short essay (no more than 700 -800 words): Describe the most relevant ethical dilemma(s) presented (no more than two). Identify the most relevant stakeholder(s) (no more than 3) and briefly describe the situation from their perspective. Analyze the dilemma, using scholarly discussion, from the perspective of the primary stakeholder (typically the patient). Include a discussion of at least two ethical theories or bioethics principles studied in the course that relate to the dilemma and issues you identified. Include any relevant legal concerns or requirements outlined in the readings. Present your assessment, resolution or potential solutions for resolving the issue. Remember that there are no right answers, per se, so reflective questions can be as appropriate as a firm conclusion. Identify how this case might cause moral distress for members of the healthcare team. Reviewing another contemporary case of the patient refusing forced feedings. Judge: Severely anorexic patient can refuse forced feedings. Identify contemporary policies, standards and laws that have been put in place to prevent similar dilemmas. Briefly explain what you have learned from examining this case. Your case analysis will be between 700 - 800 words. It will include the following: A title page with the title of the case, your name, and date Double-spaced, Times New Roman 12-point font APA formatted inline citations as appropriate A bibliography of references used Case Study: https://youtu.be/lSsu6HkguV8

Explanation / Answer

Probably the most recommendations principal to clinical ethics is that of patient autonomy. The conflict although is normally making a choice on precisely how a lot autonomy the patient possesses. Is it morally permissible to enable a sufferer to have entire autonomy? Do sufferers lose rights once they go to a doctor? Must a healthcare professional do what a patient desires or what is in the great interest of the sufferer? Adding to which is the query, if the general practitioner is to do what's in the first-class curiosity of the patient, must or will have to the healthcare professional now not also take into account the ramifications of a clinical choice on all those affected by the selection on the person? Critical to all these ideas is the proposal of told and voluntary consent, in that relating to making a scientific selection the patient must be advised and with that knowledge voluntarily consent to it. An concept contrasting patient autonomy is paternalism, which is the place the doctor would do what he or she thinks is in the satisfactory curiosity of the patient, brushing aside the patients wishes or desires. These are the particular ideas, amongst some others discussed later, to be able to be analyzed in context of the Cowart case.

Dax Cowart used to be a typical guy till a freak accident severely injured and handicapped him into the health center. A couple of times so that it will the clinic, though, Cowart requested for others to take part in his dying by means of both asking the Farmer who determined him to give him a shotgun, or asking the ambulances to no longer take him to the clinic and as a substitute let him die the place he was once. Even when Cowart reached the hospital, he requested a nurse to either supply him medicine with the intention to kill him or to do anything so that it will help him take his own existence. Neither the doctors, nor his mom would take heed to his pleas for death, and the doctors having had his mom signal a consent type for surgical procedure went on to perform it on Dax (Munson 99). Dax continuously via the rehabilitation procedure wished to die and endured to ask others to partake in his death. Later, he would go on to say that the intent he wished to die was once due to the fact the agony for the duration of the whole procedure used to be insufferable, and even though he does revel in his life now, he still believes that every individual has the proper as to what can or can not be executed to their body; patient autonomy isn't something that may be compromised, and eventually the resolution perpetually lies with the patient as to what will have to be done with their physique in a hospital.

Looking at this case, if the medical professionals had given Cowart more affliction medicine, which used to be afterwards determined they could have, then it is relatively possible that Cowart wouldn't have had this excessive desire to die. Also, he would no longer have had as robust of an opinion on patient autonomy and this evidenced in the fact that Cowart states if all of the circumstances had been the same now he would nonetheless wish to die on the grounds that he believes sufferer has proper to what will have to be carried out with their body (Munson 101). This is because if the situations would have been the same, but when extra suffering medicine had been given to Cowart, it would now not be the identical expertise or instances, and for that reason his opinion afterwards could were altogether specific. Cowart strongly believes in patient autonomy, but a further predicament to appear at right here is that Cowart had been dropped at the health facility via the ambulance. It used to be no longer the medical professionals choice to have Cowart in the medical institution, and seeing that the extent of his accidents, the medical professionals comfortably proceeded to do what that they had been trained to do of their occupation. Of direction, the obvious questions here are whether the medical professionals must normally feel the ought to keep patients or whether or not it is correct for the medical professionals to suppose that? However, considering the fact that a medical professionals whole coaching is about how you can shop lives, the doctors can't be blamed for doing what that they had been informed to do, specially considering that they noticed how many sufferers in his had continued to live comfortable lives, and so of their view they had been doing the proper thing.

In a sufferer and health care provider relationship, the patient involves the doctor and no longer vice-versa. The sufferer comes on account that the patient is seeking medical recommendation that she or he is does not have the skills or training of, and while doing so the patient is giving up a degree of autonomy to the health care provider routinely. The healthcare professionals job then, ethically speaking, can be to speak about with the sufferer what their options are, the implications of each and every, and what the health care provider thinks is the high-quality thing to do. Then the patient can either agree or disagree, and if the sufferer neglects a essential cure that's imperative for them, then it is still required of the healthcare professional to inquire why the sufferer thinks that manner and argue with the sufferer about what will have to be done. Finally, if the patient still disagrees with the health care provider on a indispensable scientific choice, then the doctor will have to inform the sufferer to sleep on it or think over it after which possibly the next day to come have another dialogue, and from there decide what the right path of action should be. This was in no way the case in Cowart"s crisis, Cowart from the beginning had been asking to no longer be handled and allowed to die, and all his pleas had been left out with the notion that Cowart was once comfortably talking out of his temporarily painful condition (Munson 99). After the cure, Cowart had still wished to die, and the doctors brought in a psychiatrist to check if he was once sane, it used to be tested he's; still, the doctors without difficulty not noted his wants. This brings about some matters to recall.

One consideration is that his mother and the medical professionals acted in a paternalistic method, in ignoring his needs and doing what they proposal was within the best curiosity for him before the remedy, and even after the therapy when he was once established to be sane. This doesn't seem to be thoroughly ethical, because it ignores a equipped sufferer's needs for what should be achieved to her or him, as a substitute the path the medical professionals must have taken, very likely after the remedy, used to be the aforementioned method of discussion. The healthcare professional should have accurately discussed with Dax what the probabilities are after rehabilitation and therapy and why he shouldn't always considering loss of life, as a substitute of effectively saying he shouldn't wish to die (Munson ninety nine). The sort of process could have given Dax an extra standpoint. If Dax nonetheless desired to die although, I feel the health care professionals response to him was proper when he instructed him that after his fingers were operated on, Dax could get a gun and shoot himself, however wants to discontinue asking others to partake in his demise. The medical professionals role on this complete system was effectively to treat him, as they will have had authorized restrictions on their capacity to act on his wants. Although these legal restrictions did not exist it could nonetheless be morally right for the medical professionals to deny Dax's desires, in mild of the skills they had of the chances Dax might enjoy after healing. However, if Dax's condition had been a lot worse, corresponding to terminal, the medical professionals act to ignore his desires might no longer were morally applicable. Regardless, the medical professionals were not utterly correct within the procedure and must have had that dialogue.

An extra limitation to keep in mind about the cure of Cowart is that whilst in many circumstances of treating patients a discussion before treatment is most commonly feasible, it would now not had been the case in Cowart's obstacle. Cowart was once in an extremely horrible condition when he got to the health center, and so the doctors had to act as quickly as viable. In their hurried movements, they advised Dax's mom on what to do and bought her to sign consent varieties (Munson ninety nine). It's possible that their action to deal with Cowart, on account that the on the spot drawback, was once permissible. They in all probability did not particularly have time to discuss with Cowart about going by means of treatment, as Cowart is just not the one patient they mainly had, and considering that his immensely horrible situation they simply needed to get the consent types signed as a way to the job they are informed to do in saving persons lives. Even as, it can be desirable that the medical professionals didn't take an instructed and voluntary consent from Dax, since his obstacle, it's nonetheless yet another difficulty as to exactly what sort of recommendation they gave to Dax's mom and if what information they had given her used to be enough for her to be informed and voluntarily signal the consent form. We do not know what exactly happened there, and that is an challenge of significance in the Cowart case in when you consider that patient autonomy.

Another fascinating perspectives to also bear in mind in the Cowart case are Utilitarian and Kantian. Cowart seems to continually argue a Kantian view that it's not ok what the health care professionals did when you consider that their movements advocate the view that the ends justify the means, which he believes violates the basic rights of a man or women to have whole autonomy over his physique (Munson 137). Apparently he believes that he should were handled as lead to himself, and not as a method for a health practitioner to avoid wasting a lifestyles. He also suggests the Utilitarian point of view of John Stuart Mill when he speaks of considering acts of self-selection that are self-related to and others-involving; in the case of self-concerning acts the man or woman must be left to their alternative (Munson 137). He believed the medical professionals didn't get his instructed and voluntary consent on his therapy when he was in the hospital. This has already been discussed above, but i'll mention just a few things in somewhat extra detail. It could no longer were thoroughly indispensable of the medical professionals to receive his instructed and voluntary consent, but the procedure of discussion with him might have been feasible. Nonetheless, what must be viewed in facets to if what the doctors did is correct in acting paternalistically is the quantity of hours and stress the doctors go by way of in treating one sufferer after one other. It could emerge as second nature to a physician to grasp precisely what the chances of a patient is of their quandary, and so in performing effectually to avoid wasting lives within the realm of the health center, a healthcare professional might deal with the sufferer in a paternalistic method; within the view of the medical professionals job within the clinic, this kind of action maybe acceptable.

One of the crucial questions within the establishing of this paper had been if the general practitioner will have to act in the pleasant curiosity of the patient or what the sufferer needs or if the healthcare professional should take into account the impacts on all people that's suffering from the cure of the patient? A Utilitarian perspective says it should be the latter of the three, but in the case of Cowart, there was really no one else external of him and his mother. His mother used to be now not based on him either. So in that view, it could were primary to bear in mind the patient's point of view more so than even his mom's. But, that is where I suppose, although every patient has the proper to reject cure, there are some possible limits to patient autonomy in seeing that must the surgeon do what the sufferer wishes or what is within the quality interest of the sufferer. As has been recounted commonly above, it isn't the case with Cowart that he was once certain to die, correctly for the medical professionals there used to be huge proof that people who had been treated in circumstances like his proceed to live best lives. Cowart even admits later that he was improper, he enjoys his lifestyles now, and that the predominant purpose for all his beliefs was once the sizeable pain he went via (Munson 137). So, for Cowart to assert what the doctors did in treating him is unsuitable, is in itself mistaken because the medical professionals carried out what their job was once to do. Cowart was no longer going to die, and had titanic prospects of a completely happy existence. The doctors knew all of this and because of this for them to hear a patient repeatedly pronouncing they wish to die, the choice borders on the ridiculous. The sufferer does not have the knowledge that medical professionals acquire via the extreme training they go by means of. So, in the case of Cowart, it is close to the logical factor to do what the doctors did due to the fact that all of this, I suppose one of the vital main issues is the viewpoint with which dying is seen. Demise shouldn't be continually always bad or excellent, it relies on the problem. In cases of neonates for illustration, it could not be a foul factor since there is no longer a lot a neonate that's struggling immensely would miss by means of death. This, of direction, changes although as age increases and there emerge as a nice many prospects of things a character could obtain, expertise, or traditionally are living an effective leisure of their life. The entire time, though, Cowart considers loss of life to be anything that's not bad, and is something almost certainly excellent because demise would relieve him from his agony. At the same time it is genuine that loss of life would have relieved him from his substantial ache, it's not the case he's terminally in poor health, and accelerated dosage of anguish treatment or better soreness medicine would have additionally relieved his anguish. That's the place the doctors fault lies. But I consider the doctors are also proper in treating him if demise is considered as some thing dangerous in the sense that it disallows potentialities of an outstanding existence, which the medical professionals knew might very well exist for Cowart. If dying is viewed in this scope, then what the doctors did in performing paternalistically used to be proper in the precise obstacle.

The implications of the medical professionals continually appearing paternalistically or the sufferer at all times having complete autonomy are harmful as they permit for a lot mistakes and mistreatments to in all probability occur. Because of this it's foremost for there to be such matters as informed and voluntary consent, and the need for dialogue between a patient and surgeon. The issue of patient autonomy is constantly going to be present, and i believe Cowart's case gives us an opportunity to evaluate what must were finished right, what most likely used to be finished right, and what the penalties of all these matters are.

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